Long-Term Outcomes in 10-Year Survivors of Early-Stage Hodgkin Lymphoma. International journal of radiation oncology, biology, physics Bates, J. E., Parikh, R. R., Mendenhall, N. P., Morris, C. G., Hoppe, R. T., Constine, L. S., Hoppe, B. S. 2020


Although radiotherapy improves progression-free survival in early-stage HL, substantial concerns remain regarding delayed normal tissue effects impacting quality of life and survival. We hypothesized that treatment with combined-modality therapy (CMT, chemotherapy and radiotherapy) improves overall survival among 10-year survivors when compared to treatment with radiotherapy or chemotherapy alone.We compared patients in the SEER database diagnosed with stage I/II Hodgkin lymphoma between 1983 and 2006 who received chemotherapy and/or external-beam radiation and survived at least 10 years. Our primary study outcome was overall survival; we additionally analyzed cause-specific and other-cause-specific survival.Of 10,443 10-year survivors of stage I/II classical Hodgkin lymphoma, 33.6% received chemotherapy alone, 23.8% radiotherapy alone, and 42.6% CMT. Median follow-up was 16.1 years. On multivariate analysis including race, stage, gender, age, and "modern" treatment in 1995+, 10-year survivors who received CMT had improved overall survival relative to survivors who received RT alone (HR=1.41, 95% CI=1.21-1.64, p<0.01) or chemotherapy alone (HR=1.35, 95% CI=1.16-1.57, p<0.01).This survival difference was driven by an increase in death due to both HL and non-HL causes in those treated with chemotherapy alone. Our analysis suggests that CMT offers optimal survivorship for patients with stage I/II Hodgkin lymphoma.

View details for DOI 10.1016/j.ijrobp.2020.02.642

View details for PubMedID 32173399